Contraceptive Care
Your Prescription Plan Covers Contraceptives at No Cost to You
Under the Affordable Care Act, your prescription plan covers contraceptive medications and medical devices approved by the U.S. Food and Drug Administration. There are many contraceptive options available to you that can help prevent pregnancy, including:
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Consult with your health care provider to ensure you are using the contraception method most appropriate for you.
SAMBA’s contraceptive benefit includes at least one option in all methods of contraception (as well as screening, education, counseling, and follow-up care).
Any contraceptive that is not already available without cost sharing on the formulary can be accessed through the contraceptive exceptions process.
- Exceptions are available through the Prior Authorization (PA) process. PA reviews can be initiated by the member, pharmacist or provider.
- Members can contact Express Scripts at 855-315-8527. Providers can initiate an electronic PA.
More information on contraceptive coverage can be found in SAMBA’s plan brochure (see page 78).
Other Resources
If you need more information or support concerning contraceptive care, these other resources are available.
Contact OPM
If you have difficulty accessing contraceptive coverage or other reproductive healthcare, you can contact OPM at contraception@opm.gov
OPM Website
For more information on contraception coverage in the FEHB Program, please visit OPM’s Contraception Coverage web page.
HHS Website
For more information on your reproductive rights, visit the Department of Health and Human Services’ Reproductive Rights web page.